Amanda Lea Fortier, PHD

Individual provider Active NPI Ph.D. Medical Genetics · Rosemont, IL

NPI 1770023202 · NPPES record last updated Mar 2, 2017

Key facts

NPI
1770023202
Entity type
Individual (NPI type 1)
Primary specialty
Ph.D. Medical Genetics 170100000X
Practice address
5400 Pearl St
Rosemont, IL 60018-5305
Phone
(847) 349-7464
Fax
(847) 349-7409
NPI assigned
Mar 2, 2017
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Philosophy

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Ph.D. Medical Genetics 170100000X Yes

Addresses

Primary practice location

5400 Pearl St
Rosemont, IL 60018-5305

Mailing address

5400 Pearl St
Rosemont, IL 60018-5305
Phone (847) 349-7464

Other providers in Rosemont, IL

All providers in Rosemont, IL · Ph.D. Medical Genetics in Illinois

Sources for this page

Verify at the official NPI Registry.